Healthcare in England: CQC response to AvMA report on safety alerts

The Care Quality Commission (CQC), independent regulator of all health and adult social care in England, has been working closely with the Department of Health and the National Patient Safety Agency (NPSA) to address concerns about outstanding safety alerts. On 1 April, CQC implemented a brand new regulatory regime and now uses information about safety alerts to monitor standards in the NHS.

In June, CQC wrote to 30 trusts that had not implemented 10 or more alerts over the past six years, according to the Central Alert System (CAS). Ian Biggs, CQC regional director, said:

“ From the evidence we’ve collected, it is not the case that trusts are simply ignoring safety alerts. In fact, in most cases trusts could demonstrate that they had taken significant action. We are scrutinising all of the trusts’ responses and if there is any cause for concern we will take action and publish our findings.”

Mr Biggs added:

“ Safety alerts are issued to protect patients and it is the responsibility of trusts to make sure they are implemented in full, every time. We now take account of safety alerts when we monitor standards in the NHS. If we find that patient safety is being put at risk we will take action.”

Mr Biggs said Action against Medical Accidents had played a pivotal role in raising the issue of safety alerts up the NHS agenda. He said: “AvMA have been a strong voice for patients. Since its report in February, there has been a significant improvement in trusts reporting compliance with alerts. We will continue to work with AvMA on this and other issues that affect patient safety.”

Examples of reasons trusts gave for not fully implementing alerts:

• simple delays in closing down alerts on CAS system
• awaiting national solutions (e.g. national spine for care records, response to complaint by British Association of Urological Surgeons)
• national deadline for one alert has been revised to November 2010 (Right patient, right blood)
• action plans are in place and many components of alert complete, but will not close down alert until complete assurance obtained, e.g. through clinical audit, sign off of draft documents
• difficulties filling vacancies
• completing roll out of training programmes
• IT issues, e.g. awaiting new system implementation
• Unable to complete the alert as specified, but controls put in place to minimise risk and issue kept on corporate risk register until closed

How CQC will use information from the Central Alert System
CQC has been working closely with the NPSA and the Department of Health to improve the Central Alert System. It will now use information to feed into its Quality and Risk Profiles (QRPs) for each trust. QRPs are a vital new tool that gather every piece of information about an organisation together in one place. QRPs do not provide judgements, but they help the regulator identify where risks might lie so it can target inspection and other regulatory action. If a trust does not implement an alert, it may mean they are not fully complying with the standards.

About the CareQuality Commission: The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England. The CareQuality Commission inspects health and adult social care services in England, whether they're provided by the NHS, local authorities, private companies or voluntary organisations. It also protects the interests of people detained under the Mental Health Act. (Until 31 March 2009, this work was carried out by the Healthcare Commission, the Mental Health Act Commission and the Commission for Social Care Inspection.)

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